Ultrasonic therapeutic apparatus

ABSTRACT

An ultrasonic therapeutic apparatus comprising an apparatus body including a drive source for ultrasonic oscillation, a hand piece including an ultrasonic vibrator and removably connected to the apparatus body, a drive unit in the apparatus body for applying voltage to the ultrasonic vibrator of the hand piece, thereby driving the ultrasonic vibrator, a probe removably connected to the hand piece and adapted to be vibrated by ultrasonic vibration produced as the ultrasonic vibrator is driven, thereby treating organic tissue, a water supply unit for supplying cooling water to cool the probe, a suction unit for removing waste matter by suction from the organic tissue treated by means of the cooling water and the probe, an ultrasonic output setting section for setting a preset value for an ultrasonic output from the ultrasonic vibrator, a feedwater output setting section for setting a preset value for a feedwater output from the water supply unit, a feedwater output control section for controlling the feedwater output setting by the feedwater output setting section so that the preset feedwater output value is a value such that the probe is cooled and is not excessively heated, and a memory unit for storing the preset values for the ultrasonic output and the feedwater output.

This is a division of application Ser. No. 08/166,520 filed Dec. 3, 1993now U.S. Pat. No. 5,462,522 issued 10/31/95.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to an ultrasonic therapeutic apparatus inwhich the distal end of a probe is subjected to ultrasonic vibration,thereby crushing or emulsifying organic tissues, and operations forcooling water supply and suction are performed.

2. Description of the Related Art

A typical ultrasonic therapeutic apparatus comprises a hand piece havingan ultrasonic vibrator therein, a probe connected to the hand piece, anda drive source unit for driving the vibrator. Since the probe is heatedby internal strain which is attributable to ultrasonic vibration, theultrasonic therapeutic apparatus is furnished with a water supplymechanism which supplies the probe with cooling water, such as aphysiological saline solution, thereby cooling the probe and washing theoperation field. The apparatus is further provided with a suctionmechanism for removing tissue pieces or crushed pieces, along with thesupplied cooling water, by suction.

The ultrasonic therapeutic apparatus with this construction can crushorganic tissues and successively remove crushed tissue pieces bysuction, by subjecting the distal end of the probe to ultrasonicvibration. This apparatus is characterized, however, in that it nevercrushes elastic tissues, such as vascular tissues, nervous tissues,etc., so that it is suited for resection of the liver and cerebralsurgery.

Among specific examples of the ultrasonic therapeutic apparatus of thistype, there is one which is provided with a mechanism capable of freelyadjusting the quantity of cooling water supply to the probe. Anotherexample is proposed in Jpn. Pat. Appln. Publication No. 3-318867 (Jpn.Pat. Appln. KOKAI Publication No. 5-168897). In this case, the apparatusis driven after preset values for an ultrasonic output and a feedwateroutput for cooling water are set by reading preset values stored in aninternal memory for the preceding cycle of operation.

According to the former ultrasonic therapeutic apparatus in which thequantity of cooling water supply can be freely set, an operator musttake the greatest care not to carry out a surgical operation with thecooling water supply at its minimum value or zero. If a preset value forthe cooling water supply is changed in the ultrasonic therapeuticapparatus of this type, the probe may not be able to be fully cooledbecause the quantity of cooling water supply is too small for theultrasonic output, or the operation field cannot be washed clean enoughto secure a distinct field of view. In such a case, the use of theapparatus must be suspended.

The latter ultrasonic therapeutic apparatus proposed in Jpn. Pat. Appln.Publication No. 3-318867 involves the same problem of the former oneunless the preset feedwater output value for the preceding operationcycle, invoked from the memory during the operation of the apparatus, isappropriate to the ultrasonic output.

Thus, in the ultrasonic therapeutic apparatus, the water supply to theprobe is an essential factor, and the probe should never fail to beproperly supplied with water before ultrasonic oscillation. If the watersupply is stopped during the ultrasonic oscillation, moreover, theultrasonic oscillation must be suspended in order to avoid theaforementioned awkward situation.

Depending on the application, the conventional ultrasonic therapeuticapparatus requires the provision of hand pieces and probes withdifferent shapes, sizes, outputs, etc. For example, there are many typesof hand pieces, including a bent type for cerebral surgery, standardtype for general surgical operation, high-power type for orthopedic orendoscopic treatment, etc. Also, the probes are varied in distal endshape and length, and some of them have a bent portion. It is pooreconomy, however, to provide many ultrasonic therapeutic apparatuses forindividual applications, and storing them is a hard task.

To cope with this, a novel system is proposed in Jpn. Pat. Appln.Publication No. 2-283322 (Jpn. Pat. Appln. KOKAI Publication No.4-158856. According to this system, a plurality of combinations of handpieces and probes can be freely selected according to the application,the selected combination is detected or discriminated, and driveconditions are set in accordance with the combination. To attain this,each hand piece is discriminated by identification means attached to itsconnector, and the type of the probe is identified by detectingimpedance by means of a control section in a drive unit. This systemeliminates the aforesaid conventional drawback that an ultrasonictherapeutic apparatus must be provided for each application, and has anadvantage in being able to be driven by means of a common drive unitdespite the change of the combination of the hand piece and the probe.

Also in this system, the water supply to the probe is essential inwashing the operation field or preventing the probe from being heated ordamaged. It is necessary, therefore, to detect or discriminate the typesof the hand piece and the probe and secure the optimum drive conditionsfor the combination of the two elements, and also, to set optimumconditions for a water supply pump, thereby adjusting the quantity ofwater supply to an optimum value corresponding to the ultrasonicoscillation output. Naturally, the drive conditions, including theoscillation output of ultrasonic vibration, in particular, are oftenexpected to be changed depending on the varied tissues, despite the useof the same hand piece and probe. In some surgical operation, thetissues to be treated may cover various regions including adiposetissue, parenchyma of the liver, ambient regions of lymph nodes andblood vessels, and the like. In this case, an optimum oscillation outputmust be set for each of the tissues.

According to the system proposed in Jpn. Pat. Appln. Publication No.2-283322, however, preset values for the oscillation output and thequantity of water supply must be changed independently by manualoperation. If the quantity of water supply is too small for theoscillation output, therefore, the probe may possibly be heated to bedamaged or cause a patient or operator to suffer a burn. If the watersupply is too much for the oscillation output, on the other hand, plentyof water flows out from the distal end of the probe into the operationfield. As a result, the operation field cannot be clear enough toadvance the operation, and the feedwater is inevitably wasted.

SUMMARY OF THE INVENTION

A first object of the present invention is to provide an ultrasonictherapeutic apparatus, in which a preset feedwater output value issecured to prevent a probe from being excessively heated during use,thereby enabling optimum-state use, and which can be operated easily andsecurely.

A second object of the invention is to provide an ultrasonic therapeuticapparatus of high safety performance, in which a common drive unit canbe used in combination with various hand pieces and probes, depending onthe kinds and conditions of surgical operations, and the probes can beprevented from being excessively heated or damaged even though presetoutput values are changed.

These objects of the present invention are achieved by an ultrasonictherapeutic apparatus constructed as follows. The apparatus comprises anapparatus body including a drive source for ultrasonic oscillation, ahand piece including an ultrasonic vibrator and removably connected tothe apparatus body, drive means in the apparatus body for applyingvoltage to the ultrasonic vibrator of the hand piece, thereby drivingthe ultrasonic vibrator, a probe removably connected to the hand pieceand adapted to be vibrated by ultrasonic vibration produced as theultrasonic vibrator is driven, thereby treating organic tissue, watersupply means for supplying cooling water to the probe, suction means forremoving waste matter by suction from the organic tissue treated bymeans of the cooling water and the probe, ultrasonic output settingmeans for setting a preset value for an ultrasonic output from theultrasonic vibrator, feedwater output setting means for setting a presetvalue for a feedwater output from the water supply means, feedwateroutput control means for controlling the feedwater output setting by thefeedwater output setting means so that the preset feedwater output valueis a value such that the probe is not excessively heated, and memorymeans for storing the preset values for the ultrasonic output and thefeedwater output.

The feedwater output control means includes recommended valuedetermining means for determining a recommended value for the feedwateroutput in accordance with the preset value set by the ultrasonic outputsetting means, and first comparing and setting means for comparing therecommended value and the feedwater output value stored in the memorymeans and setting a greater one of the compared values as the presetfeedwater output value.

In another aspect of the invention, the feedwater output control meansincludes recommended value determining means for determining arecommended value for the feedwater output in accordance with the presetvalue set by the ultrasonic output setting means, and comparing andsetting means for comparing the recommended value and the presetfeedwater output value set by the feedwater output setting means andstoring the memory means with a greater one of the compared values asthe stored feedwater output value.

In still another aspect of the invention, the feedwater output controlmeans includes minimum value determining means for determining a minimumvalue for the feedwater output in accordance with the preset value setby the ultrasonic output setting means, and second comparing and settingmeans for comparing the minimum value and the preset value set by thefeedwater output setting means and setting a greater one of the comparedvalues as the preset feedwater output value.

In a further aspect of the invention, the apparatus comprises anapparatus body including a drive source for ultrasonic oscillation, ahand piece including an ultra-sonic vibrator and removably connected tothe apparatus body, drive means in the apparatus body for applyingvoltage to the ultrasonic vibrator of the hand piece, thereby drivingthe ultrasonic vibrator, a probe removably connected to the hand pieceand adapted to be vibrated by ultrasonic vibration produced as theultrasonic vibrator is driven, thereby treating organic tissue, watersupply means for supplying cooling water to the probe, suction means forremoving waste matter by suction from the organic tissue treated bymeans of the cooling water and the probe, hand piece detecting means fordetecting the type of-the hand piece connected to the apparatus body,probe detecting means for detecting the type of the probe connected tothe hand piece, ultrasonic output setting means for setting a presetvalue for an ultrasonic output from the ultrasonic vibrator inaccordance with detection signals from the hand piece detecting meansand the probe detecting means, feedwater output setting means forsetting a preset value for a feedwater output from the water supplymeans, feedwater output control means for controlling the feedwateroutput setting by the feedwater output setting means so that the presetfeedwater output value is a value such that the probe is not excessivelyheated, and memory means for storing the preset values for theultrasonic output and the feedwater output.

Additional objects and advantages of the invention will be set forth inthe description which follows, and in part will be obvious from thedescription, or may be learned by practice of the invention. The objectsand advantages of the invention may be realized and obtained by means ofthe instrumentalities and combinations particularly pointed out in theappended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of the specification, illustrate presently preferred embodiments ofthe invention and, together with the general description given above andthe detailed description of the preferred embodiments given below, serveto explain the principles of the invention.

FIG. 1 is a general view schematically showing an ultrasonic therapeuticapparatus according to the present invention;

FIG. 2 is a flow chart for illustrating the operation of an ultrasonictherapeutic apparatus according to a first embodiment of the invention;

FIG. 3 is a flow chart for illustrating the operation of an ultrasonictherapeutic apparatus according to a modification of the firstembodiment;

FIG. 4 is a graph showing the recommended feedwater output valuecompared with the preset ultrasonic output value;

FIG. 5 is a flow chart for illustrating the operation of an ultrasonictherapeutic apparatus according to a second embodiment of the invention;

FIG. 6 is a graph showing the minimum feedwater output value comparedwith the preset ultrasonic output value;

FIG. 7 is a flow chart showing a flow chart for illustrating a preferredembodiment of water supply operation of the apparatus of the invention;

FIG. 8 is a flow chart for illustrating the operation of an ultrasonictherapeutic apparatus according to a third embodiment of the invention;

FIG. 9 is a flow chart for illustrating the operation of an ultrasonictherapeutic apparatus according to a modification of the thirdembodiment;

FIG. 10 is a schematic view showing a preferred embodiment of a watersupply mechanism of the apparatus of the invention;

FIG. 11 is a perspective view showing another arrangement of theapparatus of the invention;

FIG. 12 is a block diagram conceptually showing a detection controlsystem of the apparatus of FIG. 11;

FIG. 13 is a schematic view showing a first embodiment of a hand pieceto be connected to the apparatus of the invention;

FIG. 14 is a schematic view showing the hand piece of FIG. 13 with itscover off;

FIG. 15 is a schematic view showing a second embodiment of the handpiece to be connected to the apparatus of the invention;

FIG. 16 is a partial sectional view showing a third embodiment of thehand piece to be connected to the apparatus of the invention;

FIG. 17 is a diagram schematically showing an arrangement of a feedwatersuction system for the hand piece of FIG. 16; and

FIG. 18 is a sectional view showing a fourth embodiment of the handpiece to be connected to the apparatus of the invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Preferred embodiments of the present invention will now be describedwith reference to the accompanying drawings. FIG. 1 schematically showsthe system of an ultrasonic therapeutic apparatus according to a firstembodiment of the present invention. The ultrasonic therapeuticapparatus comprises an apparatus body 2, which contains therein acontrol section, driver circuit (not shown), etc. An operation/displaypanel 4 is arranged on the outer surface of the body 2. The panel 4 isprovided with alteration switches 28 for changing preset values of anultrasonic output and a feedwater output and a display section 29 fordisplaying these outputs.

A hand piece 12 and a foot switch 24 are removably connected to theapparatus body 2 by means of connectors 16 and 17, respectively. Inresponse to an on-off operation by means of the foot switch 24, the handpiece 12 is driven by the driver circuit.

A probe 14 is removably fastened to the hand piece 12. A sheath 15 isfitted on the probe 14 in a manner such that a passage is definedbetween the probe 14 and the sheath 15. This passage is connected to awater supply port 10 which is supplied with a physiological salinesolution for probe cooling and the like. The port 10 is connected withone end of a water supply tube 8, the other end of which is connected toa water supply tank 6. A roller pump 26 is provided in the middle of thetube 8. These elements constitute water supply means for cooling theprobe 14.

A hollow line (not shown) is defined in the hand piece 12 and the probe14, and a suction tube 18 is connected to the rear end of the hollowline. The tube 18 is connected to a suction pump 22 through a suctionbottle 20 for removing sucked substances.

Referring now to the flow chart of FIG. 2, the operation of theultrasonic therapeutic apparatus according to the first embodiment willbe described.

First, in Step S1, the apparatus is connected to the supply, and thehand piece 12 is connected to the apparatus body 2. Thereupon, thecontrol section in the body 2 detects the connection of the hand piece12, and starts water supply to the probe 14 which is connected to thehand piece 12, in Step $2. When an enabled state for the ultrasonicoutput is established, the preset output value for the preceding cycleof operation is read from an internal memory in Step S3, and the presetultrasonic output value is adjusted to the preset output value for thepreceding cycle in Step S4.

The control section is previously stored, as a recommended feedwateroutput value, with a preset output value for a feedwater quantity suchthat the probe is not heated, corresponding to the preset ultrasonicoutput value in the relation shown in FIG. 4, for example. In Step S5,the recommended feedwater output value is determined in accordance withthe read preset ultrasonic output value.

Then, the program proceeds to Steps S6 and S7, whereupon the precedingpreset value for the feedwater output previously read from the memory inthe control section is compared with the recommended feedwater outputvalue. If the preceding preset value is smaller than the recommendedvalue, the program proceeds to Step S8, whereupon the recommended valueis set as the preset feedwater output value. If the preceding presetvalue is greater than the recommended value, on the other hand, theprogram proceeds to Step S9, whereupon the preceding preset value is setas the preset feedwater output value. These preset values are displayedon the display section 29 of the operation/display panel 4.

By operating the foot switch 24 in Step S10, thereafter, ultrasonicwaves can be outputted for treatment. It is desirable to prohibitultrasonic treatment using the foot switch 24 unless the feedwater isset.

when the treatment is finished, the aforesaid preset value is stored inthe internal memory of the control section to be ready for another cycleof operation of the system in Step S11, and the operation terminateswhen the power supply is cut off in Step S12.

Thus, according to the present embodiment, the preset feedwater outputvalue with which the probe is not heated corresponding to the presetultrasonic output value can be ensured at the start of the use of thesystem. Accordingly, the probe can be prevented from being heated by theuse of the small preset feedwater output value at the start of the useof the system, so that breakage of the probe by heat and bad influenceson organic tissue can be prevented. Thus, the ultrasonic therapeuticapparatus can! always be used under proper conditions.

FIG. 3 shows a modification of the first embodiment described above. Inthis modification, the feedwater output is set in Step S11 of FIG. 2 inthe aforementioned operation according to the first embodiment.

In this case, as shown in FIG. 3, the processes of Steps Sl to S4 areexecuted in the same manner as in the first embodiment, and ultrasonicwaves are outputted for treatment by operating the foot switch 24 inStep S5. In Step S6, thereafter, the preset ultrasonic output value isstored in the internal memory.

Subsequently, the recommended feedwater output value is determined inaccordance with the stored preset ultrasonic output value in Step S7,and the program then proceeds to Steps S8 and S9. Thereupon, the currentpreset feedwater output value used in the previous process for thedelivery of the ultrasonic waves or the like is compared with therecommended feedwater output value. If the current preset output valueis smaller than the recommended value, the program proceeds to Step S10,whereupon the recommended value is stored as the preset feedwater outputvalue in the memory. If the current preset output value is greater thanthe recommended value, on the other hand, the program proceeds to StepS11, whereupon the current preset output value is stored as the presetfeedwater output value in the memory.

When the preset feedwater output value is stored in the internal memoryin this manner, the power supply is cut off so that the operationterminates in Step S12.

Thus, the same effect of the first embodiment can be also obtained bysetting the feedwater output in the process of the storage in theinternal memory of the control section.

Referring now to FIG. 5, a second embodiment of the present inventionwill be described. An ultrasonic therapeutic apparatus according to thepresent embodiment is constructed in the same manner as theaforementioned apparatus of the first embodiment except for acharacteristic program stored in the control section of the apparatusbody 2. The following is a description of the operation of thisapparatus. First, in Step Sl, the apparatus is connected to the powersupply, and the hand piece 12 is connected to the apparatus body 2, asin the case of the first embodiment. In Step S2, the control sectiondetects the connection of the hand piece 12, and starts water supply tothe probe 14 which is connected to the hand piece 12. When the enabledstate for the ultrasonic output is established, the preset output valuefor the preceding cycle is read from an internal memory, and the presetultrasonic and feedwater output values are adjusted to the preset valuesfor the preceding cycle. Ultrasonic waves can be outputted for treatmentby operating the foot switch 24 in this state.

In modifying the displayed preset values, an operator operates thepreset value alteration switches 28 on the operation/display panel 4.

When the control section detects an input operation by means of thealteration switch 28 for the preset ultrasonic output value in Step S3,the preset ultrasonic output value is modified into a new preset valueon the basis of data for the increase or decrease of the preset values.

The control section is previously stored, as a minimum feedwater outputvalue, with the preset feedwater output value with which water issupplied corresponding to the preset ultrasonic output value withoutheating the probe, as shown in FIG. 6, for example. Then, in Step S5,the minimum feedwater output value is determined in accordance with thenewly set ultrasonic output value.

When an input operation by means of the alteration switch 28 for thepreset feedwater output value is then detected in step S6, the presetfeedwater output value is modified and set in the same manner for theultrasonic output in Step S7.

Thereafter, the program proceeds to Steps S8 and S9, whereupon the newlyset feedwater output value and the minimum feedwater output value arecompared. If the current preset value is smaller than the minimum value,the program proceeds to Step S10, whereupon the minimum value is set asthe preset feedwater output value. If the current preset value isgreater than the minimum value, on the other hand, the program proceedsto Step S11, whereupon the current preset value is set as the presetfeedwater output value. These preset values are displayed on the displaysection on 29 of the operation/display panel 4.

In this state, the program proceeds to Step S12, whereupon ultrasonicwaves can be outputted for treatment by operating the foot switch 24.

For continuous treatment, the program returns from Step S13 to S3 unlessthe power supply is cut off, whereupon the treatment is continued. Theoperation terminates when the power supply is cut off.

Thus, according to the present embodiment, the preset feedwater outputvalue with which the probe is not heated corresponding to the presetultrasonic output value can be ensured during the use of the system.Accordingly, the probe can be prevented from being heated by the use ofthe small preset feedwater output value during the use of the system.Thus, the ultrasonic therapeutic apparatus can always be used underproper conditions.

Referring now to FIG. 7, a method for ensuring safety in starting theuse of the ultrasonic therapeutic apparatus will be described.

Conventionally, the ultrasonic therapeutic apparatus is brought to theenabled state for the ultrasonic output by only inputting a detectionsignal for the connection of the hand piece 12 after connecting thesystem to the power supply. Accordingly, cooling water is not fed to theprobe 14 on the hand piece 12 in the enabled state for the ultrasonicoutput during the initialization of the system. If ultrasonic waves areoutputted in this state, therefore, the probe 14 may possibly be damagedby heat. This apparatus is improved in this regard. 10 First, in StepSl, the apparatus, which is constructed in the same manner as theapparatus of the first embodiment, is connected to the power supply.When the hand piece 12 is then connected to the apparatus body 2, thecontrol section detects the connection of the hand piece 12 in Step S2.Thereafter, the apparatus body 2 is brought to a standby state for watersupply to the probe 14 which is connected to the hand piece 12. In thisstate, an instruction for the operator's water supply operation isdisplayed on the display section 29 of the operation/display panel 4.

When the operator then operates the foot switch 24 or a water supplyswitch on the operation/display panel 4 in Step S3, a signal indicativeof the switch operation is detected.

When the depression of the switch is continued, the program proceeds toStep S5, whereupon the water supply operation is performed. When theswitch is released, the program proceeds to Step S6, whereupon the watersupply operation is completed, and the enabled state for the ultrasonicoutput is established. In this state, the preset output value for thepreceding cycle is read from the internal memory, set, and displayed. Ifit is concluded in Step S7 that the water supply is not accomplished andthat the enabled state for the ultrasonic output is not established, theprogram returns to Step S4, whereupon the aforesaid processes arerepeated so that the water supply operation is completed.

By operating the foot switch 24 in Step S8, thereafter, ultrasonic wavescan be outputted for treatment.

With the ultrasonic therapeutic apparatus constructed in this manner,the operator must necessarily perform the water supply operation for asuitable period of time before the enabled stake for the ultrasonicoutput is established, after the connection of the hand piece isdetected at the start of the use of the system. Thus, the apparatus canbe used under safe conditions.

Even in case only the hand piece 12 is replaced during use, moreover,the water supply operation can be easily performed for a period of timeduring which the switch is depressed. Thus, troublesome preparations arenot required before starting the system operation.

Referring now to FIG. 8, a third embodiment of the present inventionwill be described. An ultrasonic therapeutic apparatus according to thepresent embodiment is constructed in the same manner as theaforementioned apparatus of the first embodiment, provided that aplurality of types of hand pieces 12 can be connected to the apparatus.The operation of this apparatus will be described with reference to theflow chart of FIG. 8.

After the system is first connected to the power supply in Step S1, astandby switch is depressed. In response to the operation of the standbyswitch in Step S2, the presence of the hand piece 12 to be connected isdetected in Step S3. If it is concluded that the hand piece 12 is notconnected, an instruction for the connection of the hand piece 12 isdisplayed in Step S4. If the hand piece 12 is connected, its type isdiscriminated in Step S5. The result of decision in Step S5 is used insetting the ultrasonic output and feedwater output afterward.

In Step S6, thereafter, an instruction for an advance water supplyoperation is displayed. The water supply switch is operated in Step S7,and the advance water supply operation is performed in Step S8. Water issupplied up to the distal end of the hand piece 12. In Step S9 after theadvance water supply is completed, the previously discriminated data forthe hand piece 12 is invoked from a preset data table for the ultrasonicwaves and feedwater quantity. By doing this, operations for ultrasonicoscillation, washing, and suction are allowed to be started by means ofthe foot switch (Step S10). The operation terminates when the powersupply is cut off.

The flow may be arranged so that the standby switch and the water supplyswitch are common. As shown in FIG. 9, moreover, the operation of thestandby switch may be omitted so that the hand piece 12 is discriminatedas its connection is detected.

According to the this embodiment, automatic setting of the recommendedfeedwater quantity corresponding to the ultrasonic output, whichconstitutes a feature of the present invention, may be applied to anapparatus body which can be used with various types of hand pieces 12.

As shown in FIG. 9, moreover, the present embodiment may be designed sothat the advance water supply operation for the ultrasonic oscillationcan be controlled by means of the operator-operated foot switch (StepS7) as well as the standby switch attached to the apparatus body 2 (StepS6). If neither of the switches is turned on, an instruction for theadvance water supply operation is displayed in Step S6. Thus, theoperator can successfully set up the apparatus without failing to touchthe apparatus body 2 in a foul region.

Referring now to FIG. 10, a preferred embodiment of a water supplymechanism of the ultrasonic therapeutic apparatus according to thepresent invention will be described. The apparatus body 2 is providedwith an ultrasonic oscillator section 32, a water supply section 33, anda control section 34. Also, the hand piece 12 is connected to the body2. The water supply section 33 comprises a rotor 35, a motor 36, a motorcontrol section 37, and a pump door detecting section 38. The rotor 36is fitted with a tube 39. As the rotor 36 is rotated, the tube 39 issqueezed so that water is supplied. The pump door 40 serves to cover therotating rotor 35 and presses the tube 39 against the rotor 35. Thewater supply cannot be normal unless the door 40 is fully closed. Ifunsatisfactory closing of the pump door 40 is detected by means of asensor 41 for detecting the door state, therefore, the advance watersupply operation or ultrasonic oscillation is prohibited. Also, theoperator may be informed of this situation by being warned.

According to the present embodiment, the ultrasonic oscillation cannotbe continued when the water supply mechanism ceases to performsatisfactory water supply operation after the advance water supply andultrasonic oscillation are effected.

Thus, in the ultrasonic therapeutic apparatuses according to theindividual embodiments described above, the feedwater output value isset corresponding to the preset ultrasonic output value of ultrasonicvibrators, and the probe can be restrained from being heated.Accordingly, ultrasonic waves cannot be delivered with a relatively lowfeedwater output at the start of or during the use of the apparatus, andso that appropriate water supply operation corresponding to the presetultrasonic output value can be carried out before the ultrasonicoscillation, and the apparatus can be used under good conditions.Furthermore, recommended feedwater values suited for a plurality of handpieces can be set, and lower limit values for modified setting can bedetermined in accordance with the recommended values.

FIG. 11 shows another arrangement of the ultrasonic therapeuticapparatus according to the present invention.

FIG. 11, numerals 61a and 61b denote hand pieces, which are different insize, maximum amplitude, frequency, etc. The hand piece 61a is adaptedto be fitted with probes 62a, 62b and 62c which are different in shape,size, etc. The hand piece 61b is adapted to be fitted with probes 63a,63b and 63c which are different in shape, size, etc. The probes 62a,62b, 62c, 63a, 63b and 63c can be removably mounted in variouscombinations on the hand pieces 61a and 61b. In this case, thecombinations of the hand pieces and the probes are classified into twogroups, Group A including the hand piece 61a and the probes 62a, 62b and62c and Group B including the hand piece 61b and the probes 63a, 63b and63c.

Cords 64a and 64b extend from the hand pieces 61a and 61b, respectively,and connectors 67a and 67b to be connected to a connector socket 66 of adrive unit 65 are attached to the extreme ends of the cords 64a and 64b,respectively.

Detecting means are provided for individually discriminating the typesof the hand pieces 61a and 61b, which have different drivecharacteristics, and the probes 62a, 62b, 62c, 63a, 63b and 63c.Arranged individually in the connectors 67a and 67b are discriminationelements (not shown), such as resistors, Zener diodes, etc., for use asmeans for detecting the types of the hand pieces 61a and 61b. If thediscrimination elements are resistors, their resistances are changedaccording to the types of the hand pieces 61a and 61b. If the zenerdiodes are used, their Zener voltage values are changed according to thetypes of the hand pieces.

In either case, discrimination terminals, which are connectedelectrically with the discrimination elements, project individually fromthe connectors 67a and 67b, and are connected to detecting contacts (notshown) attached to the connector-socket 66 of the drive unit 65.

Further, the drive unit 65 contains detecting means (not shown) fordiscriminating the type of the combination of the hand piece 61a or 61band the probe 62a, 62b, 62c, 63a, 63b or 63c. These detecting meansdiscriminate the types of the probes 62a, 62b, 62c, 63a, 63b and 63c bytaking advantage of the difference between the voltage or current valuesfor the ultrasonic vibration drive of the hand pieces 61a and 61b fittedwith the probes 62a to 63c. More specifically, the detecting meansdiscriminate the types of the probes 62a to 63c by detecting animpedance value (Z) given by a voltage-to-current ratio (V/I), forexample.

These detecting means are used to discriminate the types of the handpieces 61a and 61b and those of the probes 62a, 62b, 62c, 63a, 63b and63c. Based on the results of discrimination, the drive unit 65 is setunder optimum conditions according to the type of the combination of thehand piece 61a or 61b and the probe 62a, 62b, 62c, 63a, 63b or 63c.

Formed in each of the hand pieces 61a and 61b is a passage (not shown)through which a perfusate is supplied. The perfusate is used to wash theoperation field or cool the ultrasonic vibrator in each hand piece 61aor 61b and the probe 62a, 62b, 62c, 63a, 63b or 63c. The passage isconnected to a feedwater pump 69 in the drive unit 65 by means of awater supply tube 68. The feedwater pump 69 feeds a physiological salinesolution, for use as the perfusate, stored in a feed-water bottle 70,into the perfusate supply passage of the hand piece 61a or 61b, therebycooling the hand piece and the probe. The perfusate in the probe 62a,62b, 62c, 63a, 63b or 63c is supplied through a passage formed in theprobe or a passage formed of a gap between the probe and a sheath (notshown) surrounding the probe.

Formed individually in each of the hand pieces 61a and 61b and each ofthe probes 62a, 62b, 62c, 63a, 63b and 63c, moreover, are suctionpassages (not shown) for the perfusate through which the perfusate issucked in after having been used to wash the operation field. Thesepassages are connected to a suction pump 73 in the drive unit 65 bymeans of a suction tube 71 and a suction bottle 72. The perfusate issupplied and discharged through these passages.

while the perfusate is supplied to the hand piece 61a or 61b by means ofthe water supply tube 68 and the feedwater pump 69 in the drive unit 65,the necessary quantity of feedwater varies depending on the types of thehand piece 61a or 61b and the probe 62a, 62b, 62c, 63a, 63b or 63c.Accordingly, an initial feedwater value is automatically set as one ofoptimum drive conditions corresponding to the type of the discriminatedhand piece and probe, by means of an automatic feedwater quantitysetting section 74 (see FIG. 12).

A surgical operation is started under this preset condition. During theoperation, the oscillation output for ultrasonic vibration is suitablyset by means of an oscillation output setting section 75 attached to thedrive unit 65, depending on the tissue to be operated. If theoscillation output or the amplitude of the ultrasonic vibration is highor large, in this case, heat produced by the ultrasonic vibrator and theprobe 62a, 62b, 62c, 63a, 63b or 63c is great, so that the necessaryquantity of feedwater is large. If the oscillation output or theamplitude is low or small, on the other hand, the produced heat issmall, so that only a small quantity of feedwater is needed.

Since the necessary quantity of feedwater thus varies depending on thepreset oscillation output value, the automatic feedwater quantitysetting section 74, which is attached to the drive unit 65,automatically sets an optimum feedwater quantity corresponding to thepreset oscillation output value in response to a signal. S₂ from adetecting section 76 and a signal S₁ from the oscillation output settingsection 75.

According to this arrangement, the optimum feedwater quantity isautomatically set in accordance with the oscillation output, so that theultrasonic vibrator, probe, etc. can be securely prevented from beingheated or damaged even with the oscillation output varied.

The optimum feedwater quantity may be set in the processes of operationpreviously shown in the flow charts. In this case, the oscillationoutput setting section 75 sets a proper preset value in response to thesignal S₂ from the detecting section 76. In response to the signal S₁which depends on the preset value, the automatic feedwater quantitysetting section 74 automatically sets the optimum feedwater quantity.

The supplied perfusate is sucked into the suction bottle 72 for recoverythrough the inside of the probe 62a, 62b, 62c, 63a, 63b or 63c, thesuction passage in the hand piece 61a or 61b, and the suction tube 71,by the agency of the suction pump 73. The quantity of the recoveredperfusate varies depending on a preset value (sucking force) for thesuction pump 73. Accordingly, it is advisable to supply the automaticfeedwater quantity setting section 74 with information S₃ on the presetsucking force value set by means of a suction force setting section 77so that the feedwater quantity can be automatically set in considerationof the sucking force. In FIG. 11, numeral 78 denotes a foot switch forthe on-off control of the oscillation operation.

According to the arrangement described above, the feedwater quantity isalways automatically adjusted to the preset optimum value in accordancewith the oscillation output, depending on the types of the detected handpiece 61a or 61b and probe 62a, 62b, 62c, 63a, 63b or 63c or despite thechange of the oscillation output. Accordingly, the ultrasonic vibratorin the hand piece and the probe can be prevented from being excessivelyheated, so that optimum cooling can be effected with reliability. Thus,there is no possibility of a patient or operator suffering a burn, andthe ultrasonic vibrator and the probe can be prevented from beingdamaged by heat. Moreover, a good operation field can always be securedwithout being obstructed by the feedwater, so that the surgicaloperation can be carried out smoothly. Furthermore, the feedwaterquantity can be adjusted so that the perfusate can be used withoutwaste, thus, ensuring high economical efficiency.

Also, the feedwater quantity can be automatically set in considerationof the sucking force by supplying the automatic feedwater quantitysetting section 74 with the information S₃ on the preset sucking forcevalue set by means of the suction force setting section 77. Thus, thefeedwater quantity can be adjusted with higher accuracy.

FIG. 13 shows an arrangement in which a hand piece 61 is provided with asecond cover 82 separate from a first cover 81 such that the secondcover 82 can be axially removably fitted on the first cover 81. Thesecond cover 82 is rotatable around the axis of the first cover 81.

The second cover 82 is provided with a water supply connector 83 and asuction adjusting connector 86. The connector 83 is designed so as tocommunicate with a water supply passage between a probe 62 and a sheath85 surrounding the same when it is fitted with the second cover 82.Further, the second cover 82 is provided with a suction adjusting member88 having a leakage port 87 which communicates with the suctionadjusting connector 86 by means of a pressure pipe 84. The connector 86is connected with a pressure adjusting tube which opens into the middleportion of a suction tube (not shown). Also, a suction connector 90 forconnecting the suction tube is attached to the rear end of the firstcover 81.

Normally, the hand piece 61 is used with the second cover 82 fittedthereon, as shown in FIG. 13. The suction pressure can be adjusted byregulating the opening of the leakage pot 87 of the suction adjustingmember 88 by a finger.

If the suction pressure need not be adjusted, the hand piece 61 is usedwith the second cover 82 off. In this case, the hand piece 61 is fittedwith the first cover 81 only, so that its grip portion is thinner andeasier to handle than when the piece 61 is fitted also with the secondcover 82. Moreover, the operation cannot be hindered by tubes which areconnected to the water supply connector 83 and the suction adjustingconnector 86 attached to the second cover 82.

FIG. 15 shows an arrangement in which a second cover 89 is provided withthe water supply connector 83 only, and not with the suction adjustingconnector 86 or the suction adjusting member 88. The second cover 89 ofthis type and the aforesaid second cover 82 can be alternatively fittedon the first cover 81.

The probe may be cooled by means of a dual-structure sheath which iscomposed of inner and outer sheaths fitted on the probe. In thisarrangement, one of the gaps between the probe and the inner sheath andbetween the inner and outer sheaths is used as a water supply passage,and the other gap as a suction passage, the two passages communicatingwith each other at the respective distal ends of the sheaths. Accordingto this arrangement, however, the gap between the probe and 10 the innersheath serves as a suction passage 99 (see FIG. 16), so that blood andtissue pieces from an operated region are sucked into the gap. In somecases, a leakage hole 100, which communicates with a suction passage 93in the bore of the probe, may be blocked. If the hole 100 is blocked,the probe cannot be cooled appropriately, and the fed fluid flows outdirectly into the operated region. As a result, the operated region issubmerged, so that a satisfactory field of view cannot be enjoyed.

FIGS. 16 and 17 show an ultrasonic therapeutic apparatus which isarranged so as to solve the above problem. A probe 92, which isconnected to a hand piece 91, is formed of a hollow member whose boreconstitutes a first suction passage 93. The probe 9 is surrounded by adual-structure sheath 96 which is formed inner and outer sheaths 94 and95.

The gap between the inner and outer sheaths 94 and 95 of thedual-structure sheath 96 constitutes a water supply passage 97, whichcommunicates with a water supply passage 98 of the hand piece 91. Thegap between the inner sheath 94 and the probe 92 constitutes a secondsuction passage 99. The passage 99 communicates with the first suctionpassage 91 by means of the leakage hole 100 in the side wall of theprobe 92. Also, the passage 99 is connected to a suction pump 103 bymeans of a suction tube 101 and a suction bottle 102, as shown in FIG.17, so that sucked substances collect in the bottle 102.

A flow sensor 104, which is provided in the middle of the suction tube101, continually observes the intake through the tube 101, and a signalfrom the sensor104 is fed back to a drive unit 105. Thus, in case oftrouble, an alarm can be given, or the water supply or ultrasonicoscillation output can be stopped.

Normally, almost all the perfusate carried through the water supplypassage 98 is recovered by suction through the second suction passage99, leakage hole 100, and first suction passage 93. Thus, the quantityof the perfusate flowing out into the operation field through the distalend of the probe 92 can be minimized, so that the operation field can bekept in a favorable state.

If the leakage hole 100 is blocked by blood or tissue pieces, theperfusate can hardly be recovered through the second suction passage 99and the hole 100, and almost all the perfusate inevitably flows out intothe operation field through the distal end of the probe 92.

Thus, the intake through the suction tube 101 is less than in the normalstate. A change of the intake is detected by means of the flow sensor104, whereby he blocking of the leakage hole 100 can be recognized.

The flow sensor 104 may be provided in any other portion than the middleportion of the suction tube 101, provided it is situated on the suctionpump side of the leakage hole 100. For example, the sensor 104 may belocated in the suction passage 93 or near the suction bottle 102.

Since the blocking of the leakage hole 100 can be detected in thismanner, the probe 92 can be prevented from being damaged, and theperfusate can be prevented from flowing out into the operation field andspoiling the field of vision.

FIG. 18 shows a hand piece 111 of another ultrasonic therapeuticapparatus. A horn 113 serves to enlarge the amplitude of axialultrasonic vibration produced in an ultrasonic vibration element section112 for generating ultrasonic vibration. The enlarged ultrasonicvibration is transmitted to an ultrasonic transmission member (probe)114. The distal end of the transmission member 114 is used to cut oremulsify the affected tissue or crush a calculus.

Moreover, this ultrasonic therapeutic apparatus is provided with alining plate 115 for sympathetic balance. The ultrasonic vibrationelement section 112, horn 113, and lining plate 115 are fixed togetherby means of a bolt 117 and a nut 118, thus constituting an integralultrasonic vibrator section 116. The vibrator section 116 has a suctionhole 119 therein, which communicates inside with the bolt 117, horn 113,and ultrasonic transmission member 114. A suction pump (not shown)communicates with the suction hole 119 by means of a suction tube 121.The cut or emulsified tissue or crushed calculus is removed by suctionthrough the suction hole 119 by means of the sucking force of thesuction pump.

For the manual control of the suction pressure, a connecting member 122having a branch passage is provided in the middle of the suction tube121 which communicates with the suction hole 119, and a flexiblepressure tube 123, which communicates with the tube 121, is connected tothe branch passage of the member 122.

The pressure tube 123 is connected to a suction pressure adjustingmember. 125 which has a suction pressure adjusting hole 124. A suctionleakage through the adjusting hole 124 can be controlled to adjust thesuction pressure through the suction hole 119 by regulating the openingof the hole 124 with the bulb of a finger.

The suction pressure adjusting member 125 is mounted on a cover 126 ofthe hand piece 111. The cover 126 is provided with a water supplyconnector 127 for supplying a perfusate to a region to be subjected toultrasonic treatment. A flexible water supply tube 128 is connected tothe connector 127. The perfusate is fed pressurized to the connector 127through the tube 128 by means of a feedwater pump (not shown). Theadjusting member 125 is freely rotatable around the cover 126 of thehand piece 111 so that it can be handled in conformity to the size ofthe operator's hand or desired angle. The water supply connector 127 andthe adjusting member 125 constitute an integral second cover 129. Thesecond cover 129, which is rotatable around the cover 126, can be easilyattached to and detached from the cover 126.

A manifold 131 is screwed in the front portion of the cover 126 so as topress a flange portion of the ultrasonic vibrator section 116. Thus heldbetween the cover 126 and the manifold 131, the vibrator section 116 isfixed with respect to the cover 126. A circumferential groove is formedon the outer peripheral surface of the front portion of the manifold131, and the second cover 129 is fitted on the manifold 131 from thefront side so as to cover the groove 132. An O-ring 134 is provided oneach side of the groove 132, whereby the interface between the secondcover 129 and the manifold 131 is kept watertight. An outlet 135 of awater supply passage 133 in the second cover 129, which communicateswith the inside of the water supply connector 127, is situatedcorresponding to the groove 132 of the manifold 131. A hole 136 is boredthrough the base of the groove 132 so as open into the bore of themanifold 131. The perfusate flows out into the groove 132 through theoutlet 135 of the water supply passage 133 in the second cover 129, andthen gets into the bore of the manifold 131 through the hole 136. Asheath 137 is fixedly screwed to the front of the manifold 131. Themanifold 131 and the sheath 137 are penetrated by the horn 113 and theultrasonic transmission member 114 continuous therewith. The perfusateis fed through a passage defined between the transmission member 114 andthe sheath 137.

Also available is a second cover (not shown) which. is furnished withwater supply means without including a suction pressure adjustingmember. This second cover and the second cover 129 are freelyreplaceable with each other.

As described above, the second cover 129, along with the suctionpressure adjusting member 125, can freely rotate around the cover 126,so that the operator can perform a surgical operation with the gripadjusted to the size of his or her hand or desired angle before orduring the operation. When the adjusting member 125 is rotated,moreover, the water supply connector 127 rotates together around theouter peripheral surface of the first cover 126. Accordingly, thepressure tube 123 and the water supply tube 128, which are connected tothe adjusting member 125 and the connector 127, respectively,simultaneously rotate around the cover 126 without getting tangledtogether. Since the second cover can be easily replaced with the onewhich is furnished with the water supply means without including thesuction pressure adjusting member, furthermore, the adjusting member 125never hinders the grip on the hand piece 111 in the case of a surgicaloperation which requires no suction pressure adjustment.

Additional advantages and modifications will readily occur to thoseskilled in the art. Therefore, the invention in its broader aspects isnot limited to the specific details, representative devices, andillustrated examples shown and described herein. Accordingly, variousmodifications may be made without departing from the spirit or scope ofthe general inventive concept as defined by the appended claims andtheir equivalents.

What is claimed is:
 1. A method of setting a value of an output from anultrasonic therapeutic apparatus and of treating an organic tissue bymeans of the ultrasonic therapeutic apparatus, wherein the ultrasonictherapeutic apparatus comprises an ultrasonic apparatus main bodyincluding a source of ultrasonic oscillations to produce ultrasonicwaves, a hand piece removably connected to the ultrasonic apparatus mainbody, a probe which contacts an organic tissue and which is removablyconnected to the hand piece, and a cooling water supply which suppliescooling water to the probe, the method comprising the steps of:detectingwhether or not a handpiece is connected to an ultrasonic apparatus mainbody; feeding cooling water to a probe connected to the hand piece whenit is detected that the hand piece is connected to the ultrasonicapparatus main body; detecting whether or not a feedwater output valueis fed to the probe; and then establishing a state where ultrasonicwaves can be outputted to the probe so that ultrasonic treatment oforganic tissue can be performed after said feedwater output value is fedto the probe.
 2. The method according to claim 1, further comprising thestep of urging an operator to feed cooling water to a probe beforehand,after detection of connection of a hand piece to the ultrasonicapparatus main body.
 3. A method according to claim 1, wherein when itis detected that a handpiece is not connected to the ultrasonicapparatus main body, an instruction for an operator to connect a handpiece is displayed.